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General NPI Number Information
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NPI Number | 1225619695
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Entity Type | Individual
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Provider Name | JORDAN ALEXANDRA NAVALLE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/17/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 14900 JONES MALTSBERGER RD
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City | SAN ANTONIO
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State | TX
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Zip | 78247-3919
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Country | US
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Telephone | 210-496-9545
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Fax |
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Provider Business Mailing Address
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Address Line | 201 ASHLER DR
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City | GREER
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State | SC
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Zip | 29650-5348
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Country | US
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Telephone | 864-270-5161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 42731
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 30086
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH032571
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 69239
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License Number State | TX
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